大小YAG光斑在有晶体眼眼内晶体植入术前虹膜周边切除术中运用的比较

Comparison of the size of YAG flare in implantable contact lens with intraocular lens implantation and peripheral iridectomy

目的 比较大小光斑YAG在有晶体眼眼内晶体植入术前虹膜周边切除术中的临床意义.方法 临床病例对照研究.将70例病例随机分成A和B组,A组34例采用大YAG光斑虹膜周边激光（250μm能量11～13 mJ）,总能量在上方11点1点虹膜根部形成穿孔约1 mm×2 mm.B组36例采用小YAG光斑虹膜周边激光（100 μm能量11～13 mJ）,总能量在上方11点1点虹膜根部形成穿孔约1 mm×2 mm.观察激光术后眼压变化.结果 A组大光斑与B组小光斑,2h后高眼压（眼压升高≥8 mmHg）病例无显著差异,24 h后眼压升高≥8 mmHg者（A组9例、B组3例）的两组间差异有统计学意义（P＜0.05）.结论 大光斑YAG激光在虹膜周边切除术中造成虹膜脱色素、炎性反应和眼压升高;较小光斑YAG激光在虹膜周边成孔有优势,对临床虹膜激光成孔,尤其虹膜基质较厚色素较多的患者有临床意义.

Objective To compare the clinical significance of large and small spot YAG in Iridectomy before the Implantable Collamer Lens （ICL） implantation.Methods Seventy cases were randomly divided into group A and B,group A of 34 patients with large YAG spot iris peripheral laser （250um energy,the total energy ll-13mJ at the top 11 o＇clock to 1 o＇clock direction iris roots perforation of about 1 × 2mm） group B of 33 cases with small YAG spot iris peripheral laser （100um energy,the total energy ll-13mJ at the top 11 o＇clock to 1 o＇clock direction iris root perforation of about 1 ×2mm）.Observation of intraocular pressure changes after laser surgery.Results Group A large spot and group B small spot get high intraocular pressure two hours later （Increased IOP 8 mmHg）.There was no significant difference between the two groups,intraocular pressure increased 24 hours later （Increased intraocular pressure 8mmHg）.Conclusions The small-spot YAG laser in the peripheral iridectomy produces iris depigmentation,causes inflammatory response,increase intraocular pressure.The larger spot YAG laser iridotomy has advantages in hole forming of the iris peripheral edge,it has clinical significance to clinical iridal laser drilling,especially in patients with thicker iris stroma and more pigments.